| NPI | 1710277231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: PA SP011129) |
| Additional Taxonomies | 163WP0200X Registered Nurse Pediatrics (Licence: PA RN584425) |
| 363L00000X Nurse Practitioner (Licence: DE LJ-0000346) | |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2019-03-27 |